Simply Me Therapy


4 Stages of Cognitive Development…as it Compares to Children with Autism

As I attend open houses with my daughter seeking out the college of her dreams, it brings me back to my undergraduate years when I was a Psychology major at Wagner College. I ponder on the stages of cognitive development …

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As I attend open houses with my daughter seeking out the college of her dreams, it brings me back to my undergraduate years when I was a Psychology major at Wagner College. I ponder on the stages of cognitive development and compare this to my little ones with autism.

1. Sensory Motor intelligence:  As infants, we are exposed to an influx of sensory stimulation.  Here is where the process of learning about our world, via internal sensory feedback or external sensory feedback.  Internal sensory feedback is when we recognize we are hungry.  As babies, we cry.  And as adults, if we are very hungry, we may cry as well. :). External sensory feedback is when we receive information through visual, auditory, tactile, olfactory, and kinesthetic input. A combination of sensory information leads to cognitive, emotional, and motor responses.  In autism, however, some of the sensory input may be too much information for the child’s system or not enough information, manifesting as a child who lines up cars, flaps, spins, or even smells everything.  The child is really incorporating one sense they can handle and feel in control with, while disregarding other senses that may be too much information, making them feel out of control.  They are interpreting the world differently than the neurotypically developing child, yet they are still interpreting the world.

2. Preoperational Thought: Here is the second stage of cognitive development, where individuals represent thoughts via imitation, symbolic play or drawing, language, and speech production. To process this, neurons are firing in the brain.  In autism, however, these neurons are either under active or overactive, causing difficulty in imitating, utilizing symbolic play, drawing, language, and speech.  Yet, we tend to regard this as though our children with autism do not receptively understand.  How can we know that for sure?  Perhaps, motorically, this child has difficulty imitating.  Or, perhaps the symbolic play we choose to introduce to our kids is being hindered by the sensory input causing an emotional reaction.  We must always assume that our children with autism can learn.  They may learn differently, but nevertheless, they can learn.

3. Concrete Operational Thought: Here, an individual is able to categorize, understand causal relationships, and solve problems as it relates to the physical world. In short, an individual reasons about real objects and the relationships between them. Thinking exists based on exposure through theoretical knowledge and/or personal experience. Yet, many individuals with autism (and lots of neurotypically developing children) who do not have opportunities for exposure to specific experiences, demonstrate a lag at this stage.  Here is where education is crucial. Children who are exposed to more and more education and opportunities for practical application excel at this stage. Our kids with autism may try to gain understanding of their environment by repeating what they hear, or as we call it, scripting.  They may gather information through flapping or spinning.  Let’s take these strengths of verbal, auditory, and kinesthetic input and educate our kids.  We simply can’t stop teaching and moving forward with exposure to learning.  Let’s pick our battles, and help our kids to move forward rather than focusing only on behavior programs because they are not acting the way we expect.  Yes, we want to facilitate socially appropriate citizens, but sometimes, we have to question how we can use the place they are, and build from there to help expose and educate.

4. Formal operational Thought: This stage allows individuals to create laws and rules for problem solving. It is based on reflection of the philosophy of the world we live in. There is a focus in planning and incorporating strategies. In children with autism, the perception of the physical reality may not match the reality one would expect.  This is related to the previous stages being altered, causing this stage to manifest in a fragmented fashion. Again, we need to assess if the reasons are related to motor, sensory, and/or emotional.  From there, we can create opportunities for learning, while accepting the individual differences that make us all unique.

When I look into the eyes of my clients, I see a child.  I don’t see autism or any other label we as a society choose to give.  I see a child who requires a different way of learning, but can learn nonetheless.  I see differences which should be embraced.  Just as I seek out different colleges for my daughter, and respect her choices of which school best fits HER needs, we all must respect that ALL of us have different needs.  Each of us is special.  So, I guess we all have special needs.


  Posted by Simplymetherapy on October 21, 2014  /  Tags: , , , ,

A Ticket To Heaven

Yesterday was one month since I lost an angel here on Earth.  It compels me to tell my story. At the tender age of 12, I lost my mother to Lithium poisoning from a diagnosis of bipolar disorder.  Five months …

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get-attachment-1.aspxYesterday was one month since I lost an angel here on Earth.  It compels me to tell my story.

At the tender age of 12, I lost my mother to Lithium poisoning from a diagnosis of bipolar disorder.  Five months later, my father was taken from a massive heart attack.  It was here that the nightmare, the transformation, and the miracles began.

I vividly recall my own screams after hearing the harsh words from my Aunt, “God took her with him, God took your mother”.  How did this happen?  Two hours before, I was watching the movie “Tootsie” with my cousins.  I knew my mother was in the hospital, but this was an ongoing occurrence throughout my life. Every few months, my mother ended up in the hospital.  The medicine made her sick, she was starving herself again, or her depression got the better of her.  It was all I knew.  But, she always came home.  Always!! How was this time different?  What would I do? Where would I go? Who will take care of me? Who will love me?  Little did I know that these would be the questions I would ask myself over and over for many years to come.  And if this wasn’t enough of a tragedy, I remember my sister pulling me into the bathroom to tell me news that would certainly break me.  “Daddy is really our step father.  We have a real father. And he is waiting to meet you in the other room!”  My life was a lie.  I was shocked, heartbroken, and lost. I met this man they claimed was my father.  He was nice enough. But, he was not my Daddy.  I was a Daddy’s girl, and this man would never be my hero.  I begged and begged to go back to Brooklyn to be with my father, or step father as some would call him. But, when I got home, everything was different. He was not the same man.  He was with another woman.  She was nothing like my mother.  The resentment I felt drove a wedge between us.  On the eve before his death, he asked me to kiss him goodnight.  It was the one and only time I refused to kiss my daddy goodnight.  The next morning, he was gone.

The guilt, the absence, the loneliness is a difficult thing to express.  Words cannot justify such a dark place.  With the chip on my shoulder that I protected for years, and the anger and disgust I felt for life, people, and myself, I chose to stay in Brooklyn rather than go back to Florida with the rest of my family.  Sad, isn’t it?  A 12 year old had a choice as to where to live.  But, yes…I did!  It was proof that I was no longer loved in this world.  I was abandoned. Oh my GOD, I was an orphan!

I continued to go through the motions of life, living from house to house experiencing all sorts of abuse I don’t care to revisit right now.  I was unhappy.  I was stripped of my childhood in the blink of an eye. Still, I found one sanctuary for myself, one release from all the horror…school.  I know so many people claim to dislike school, but for me, I pretended my teachers were my parents, my classmates were siblings, and the school itself was home.  I distinctly remember this one particular day that I received my report card.  It was like no there.  I earned straight As and the most complimentary comments from my high school professors. I silently cried.  Who can I share this with?  Who will care?  No one.  So, I shoved my report card in my backpack, and was walking out the door, when I was approached by my biology teacher.  He noticed my silent tears and inquired.  I broke down. I disclosed all the horrible abuse I was facing, and simply sobbed in this man’s arms for what felt like an eternity.  He didn’t say a word.  He didn’t rush me.  He simply hugged me right back.  After that day, I was called to his office, where I was instructed to report to each and every day after school to complete my homework and studies.  My name was then called on the loudspeaker to report to the school social worker’s office, where my biology teacher was waiting with some administrators.  Together, they helped me file to become an Emancipated Minor.  I was now fully responsible for myself.  At this point, I was 15 years old.  I was given a phone number and instructed to call at any hour if necessary.  On many occasions, my teacher came to my assistance at 3a.m.  He soon introduced me to his wife and children, and I established a wonderfully close relationship with them.  My teacher was slowly becoming my father.  It was as though he was dropped into my life from the heavens and was saving me.

Years later, I found out that my biology teacher was offered a position at a local high school nearer to his home.  I had not yet graduated, so he declined.  He explained that he would not ever abandon me.  And he didn’t!  After helping me decide on which college I would attend, he brought me to Wagner College which was my first choice.  He lived nearby, and would check in on me often.  When I graduated college, I needed a place to stay.  I lived with my teacher and his family until I was able to get my own apartment.  When I needed a car, he loaned me the money for my very first car.  I paid him back every dime.  I was so grateful.  When my husband proposed to me, my teacher approved of him…unlike the boyfriends in the past.  Who better to give me away at my wedding?  I asked my teacher and it was a proud moment for him.  When my children were born, he was one the first people to hold my babies in his arms.  And for a moment, when I was feeling lost again, not too long ago, my teacher reminded me of who I am.  He reminded me of all the lessons he taught me throughout the years.  He reminded me to love myself.  He reminded me to have fun because life was wonderful.  And I listened to him.  I listened to all his instructions because he was my teacher.  He taught me biology, but more importantly, he taught me about life.  He taught me how to love myself, and he taught me that I am capable of greatness.

When he was sick, I stayed by his side until the very end.  Even in his last days, he looked at me, and in his silence, he spoke a thousand words.  He told me everything was going to be just fine. I will be OK.  I know he knows I was there.  There was nowhere else I would have rather been.  My teacher saved my life.  He gave me a family, and he gave me back myself.  I love Mr. Shulman.  He came down from the heavens and was my angel here on Earth.  And now he went up to heaven and is an angel I now can call by name.  I was “his ticket to heaven” and I am honored, privileged, and grateful.  I will miss you with every fiber of my being.  And I love you even more than that.  Thank you Mr. Shulman, thank you!

  Posted by Simplymetherapy on September 28, 2014

Labels, Labels, Labels…

Labels for Education

Recently, I was asked to get a second opinion on a mammogram and ultrasound that showed a nodule on the left breast.  With barely enough energy to muster the strength to do so for fear of the dreaded label that …

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Labels for EducationRecently, I was asked to get a second opinion on a mammogram and ultrasound that showed a nodule on the left breast.  With barely enough energy to muster the strength to do so for fear of the dreaded label that I faced with my sister experiencing a double mastectomy only two years prior, I somehow managed to make all the contacts necessary to follow through. At my visit, I was asked to wait for the doctor to review my films because a biopsy was needed.  I was seated in a waiting room with several other women awaiting the reports of their films as well. Interesting how the Universe works!! There were lots of technical difficulties on this particular day at the hospital, and we women were waiting together for what amounted to eight full hours; a full work day filled with mental exhaustion and anguish. Among these women were different cultural backgrounds, different races, and socioeconomic statuses. All the preconceived notions for all the different women may have been present, but it was hardly noticed once we all began to converse.  For a moment in time, we all connected with one particular experience…one that we all related to; one that showed no preference for religion, color, or affluence. For this one moment in time, we were one.  There were no labels and no preconceived notions.  We were just women supporting each other through a scary time. In spite of my fears, I reflected on this and thought how fortunate I was to have experienced this connection with no prejudices to speak of. It made me realize the harshness of labels and the injustice it does for humanity as a whole.  And although one may argue that labels have their place, and may be necessary under particular circumstances to move forward, I question what a world would be like if not for the labels we place on it. We spend so much time saying something or someone is good or bad.  But isn’t good and bad a relative term?  For instance, one may believe losing a job is a bad thing.  But, if losing that job opened you up for a new experience and new opportunity that was in fact more fulfilling, would you then label losing the job as bad?

We use labels for so many circumstances.  We read tons of labels for the foods we eat, as is recommended when dieting, yet we are having the largest obesity crisis we have ever known.  Have the labels benefitted us?  We do the same for our children. My client’s mother cries…genuinely cries every three years when her son gets reevaluated.  The tests indicate extremely low scores, labeling him as multiply handicapped or rather many kinds of specific learning disorders.  Are these labels benefitting my client or his mother?  Some may say that it is, so he can be classified correctly and receive the services he needs.  But, at what point can we stop labeling him and just treat him according to his needs?  In other words, his mom was fine and happy knowing she has been doing all she can for her son, and going about her life.  Yet, once the tests were implemented and the labels were passed out, and nothing other than that had changed, she was tormented and needed time to come to a place of acceptance. My heart aches each time she goes through this, and all I can do is be present.  I tell all my client’s parents to let go of the labels.  Your child is simply that…a child! It would be interesting to experience what would happen if we let go of the diagnoses.  Would we treat these children differently?  Would the therapy services differ?  And what would happen if we let go of the religion or color or socioeconomic status of a person, and simply regarded them as…a person?

Sadly, we are a long way from deleting labels in our thoughts and in our vocabulary.  Yet, I had a glimpse of utopia where several people came together and were one.  I asked myself if this scary experience was in fact a “bad” experience or a “good” one.  Once I surrendered the fear and opened up to the love in that room pouring from each and every woman, my name was called.  I am well!  All is well!

  Posted by Simplymetherapy on August 7, 2014  /  Tags: , , , ,